Plain Language Summary Publication: Efficacy of an educational website on headaches in schoolchildren: A cluster randomized controlled trial

Main Finding: An educational website designed for children and adolescents successfully improved their knowledge about headaches. It also slightly reduced the use of passive coping strategies, such as going to bed; however, it did not lead to changes in headache frequency, medication use, or school absences. Motivation (Problem): Primary headaches, such as tension-type headache and migraine, are common in children and adolescents. They harm the quality of life, increase healthcare costs, and often persist in adulthood. Intervening early may help prevent headaches from becoming chronic. Educating young people is an important first step in empowering them to manage their headaches effectively. Yet, there is little research exploring such headache education in school settings. Methods: The study involved 814 fifth and sixth graders. Data were collected between November 2021 and April 2022. The participating classes were randomly assigned to either the intervention group or the control group. Guided by a workbook, students in the intervention group accessed the educational website during a 90-min lesson in class. They could also access the website on their own afterward. Access to website and workbook was given to the control group after the study period ended. Data were collected at four timepoints. The first was before the intervention group got the intervention. The three later timepoints were each 4 weeks apart. The researchers assessed changes in headache-related knowledge, pain coping strategies, headache frequency, medication use, and school absences. Results: The intervention group increased their headache-related knowledge a lot and slightly reduced their passive pain coping strategies compared to the control group. However, there were no significant differences between the intervention and control group regarding changes in headache frequency, medication use, or school absences. Implications (for the future): The educational website is an effective tool for increasing knowledge about headaches, which is a vital step toward better headache management. Participants in the intervention group also reported changes in their use of passive pain coping strategies. This indicates that the website has the potential to improve behavior over time. However, these changes were not significant, and headache symptoms remained similar as well. To achieve a greater impact, the intervention could include tailored follow-up sessions, more interactive elements, or be part of broader headache management strategies. These enhancements may help children to apply their knowledge in practice. This may lead to meaningful behavior changes and improved health outcomes. Henrike Goldstein: Conceptualization; data curation; formal analysis; investigation; methodology; project administration; validation; visualization; writing – original draft. Lisa-Marie Rau: Data curation; formal analysis; methodology; software; supervision; validation; visualization; writing – review and editing. Clarissa Humberg: Data curation; formal analysis; software; writing – review and editing. Verena Bachhausen: Investigation; writing – review and editing. Lorin Stahlschmidt: Conceptualization; supervision; writing – review and editing. Julia Wager: Conceptualization; funding acquisition; investigation; methodology; project administration; resources; supervision; validation; writing – review and editing. The authors would like to thank all participating students, staff, and directors who made this study possible. Additionally, the authors would like to thank Alexandra van der Valk for editing the manuscript for English language. This study is part of the “Chronic headache in adolescents: The patient perspective on health care utilization” (CHAP) study supported by the German Federal Ministry of Education and Research (grant number 01GY1615). The funding source had no role in the study's design or execution; collection, management, analysis, and interpretation of data; manuscript preparation; or the decision to submit the manuscript for publication. The study was preregistered in the German Clinical Trials Register (identifier: DRKS00027065). Henrike Goldstein, Lisa-Marie Rau, Clarissa Humberg, Verena Bachhausen, Lorin Stahlschmidt, and Julia Wager have no conflicts of interest with respect to the research, authorship, or publication of this article. Data and program codes are available upon request.